Individual
JANICE NICOLE TILLMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7800 W OUTER DR STE 300, DETROIT, MI 48235-3458
(313) 283-5135
Mailing address
20547 MURRAY HILL ST, DETROIT, MI 48235-2132
(313) 283-5135
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801099132
MI
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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